TEST BANK RATIONALE: PSYCHIATRY EOR
= = = = =
EXAM (2026/2027 UPDATED) = = =
=
Domain 1: Depressive Disorders ; Bipolar and Related
= = = = = = =
Disorders (17%) = =
1. A 32-year-old female presents with a 3-
= = = = = =
week history of depressed mood, anhedonia, fatigue, poor
= = = = = = = =
concentration, and insomnia. She reports a recent stressful life
= = = = = = = =
event but states her symptoms are "different from normal
= = = = = = = = = =
sadness" and she has had thoughts of "not wanting to wake up.
= = = = = = = = = = =
" Which diagnosis is most consistent with her presentation?
= = = = = = = = =
• A. Adjustment disorder with depressed mood • B. Major
= = = = = = = = =
depressive disorder = =
• C. Persistent depressive disorder (dysthymia)
= = = = =
• D. Bereavement
= =
Answer: B = =
,Rationale: Major depressive disorder requires at least 2 weeks of
= = = = = = = = = =
depressed mood or anhedonia plus at least four additional
= = = = = = = =
symptoms (fatigue, concentration difficulties, insomnia, suicidal
= = = = = = =
ideation) . The patient has a 3- = = = = = =
week duration, multiple symptoms, and functional impairment.
= = = = = = =
Adjustment disorder requires an identifiable stressor and symptoms
= = = = = = =
within 3 months of the stressor, but the symptom severity and suicid
= = = = = = = = = = = =
al ideation suggest MDD. Persistent depressive disorder requires 2
= = = = = = = = =
years of symptoms. Bereavement is a normal grief response and
= = = = = = = = = =
would not typically include suicidal ideation.
= = = = = =
Cognitive Level: Analysis | Exam Domain: Depressive Disorders
= = = = = = = =
=
2. A 45-year-old male presents with a 2-
= = = = = =
year history of chronic depressed mood, low self-
= = = = = = =
esteem, and feelings of hopelessness. He states he has "never
= = = = = = = = = =
felt really happy" but can function at work. Which diagnosis is
= = = = = = = = = = =
most consistent with his presentation?
= = = = =
• A. Major depressive disorder
= = = =
• B. Persistent depressive disorder (dysthymia)
= = = = =
• C. Adjustment disorder
= = =
, =
• D. Bipolar II disorder
= = = =
Answer: B = =
Rationale: Persistent depressive disorder (dysthymia) requires
= = = = = =
depressed mood for at least 2 years in adults, with at least two ad
= = = = = = = = = = = = =
ditional symptoms (poor appetite, insomnia, low energy, low self-
= = = = = = = =
esteem, poor concentration, hopelessness) . The chronic course and
= = = = = = = = =
ability to function despite depressed mood are characteristic of
= = = = = = = =
dysthymia. Major depressive disorder may have distinct episodes
= = = = = = = = =
with return to baseline. Adjustment disorder is time-
= = = = = = =
limited after a stressor.
= = = =
Cognitive Level: Comprehension | Exam Domain: Depressive
= = = = = = =
Disorders =
=
3. A 28-year-old female presents with a 3-
= = = = = =
day history of elevated mood, decreased need for sleep,
= = = = = = = =
= grandiosity, and increased goal- = = =
directed activity. She reports this is the first time she has felt
= = = = = = = = = = = =
"this good" and has been spending excessive money. What is
= = = = = = = = = =
the most likely diagnosis?
= = = =
• A. Major depressive disorder
= = = =
, • B. Bipolar I disorder, manic episode
= = = = = =
• C. Bipolar II disorder, hypomanic episode
= = = = = =
• D. Cyclothymic disorder
= = =
Answer: B =
Rationale: A manic episode requires at least 1 week of abnormally
= = = = = = = = = =
elevated/irritable mood and increased energy, plus three or more
= = = = = = = = =
symptoms (grandiosity, decreased need for sleep, pressured spee
= = = = = = = =
ch, flight of ideas, distractibility, increased goaldirected activity, ris
= = = = = = = =
ky behaviors) . The symptom duration and severity (excessive spen
= = = = = = = = =
ding, functional impairment) indicate a manic episode consistent wit
= = = = = = = =
h Bipolar I disorder. Hypomania requires 4 days and less impairme
= = = = = = = = = =
nt. Cyclothymic disorder requires 2 years of cycling.
= = = = = = = =
Cognitive Level: Analysis | Exam Domain: Bipolar Disorders
= = = = = = = =
=
4. A 34-year-
=
old male with bipolar I disorder is prescribed lithium. What base
= = = = = = = = = =
line labs should the provider order before initiating therapy?
= = = = = = = = =
• A. Complete blood count and liver function tests
= = = = = = = =
• B. Serum creatinine, BUN, TSH, and pregnancy test
= = = = = = = =
= = = = =
EXAM (2026/2027 UPDATED) = = =
=
Domain 1: Depressive Disorders ; Bipolar and Related
= = = = = = =
Disorders (17%) = =
1. A 32-year-old female presents with a 3-
= = = = = =
week history of depressed mood, anhedonia, fatigue, poor
= = = = = = = =
concentration, and insomnia. She reports a recent stressful life
= = = = = = = =
event but states her symptoms are "different from normal
= = = = = = = = = =
sadness" and she has had thoughts of "not wanting to wake up.
= = = = = = = = = = =
" Which diagnosis is most consistent with her presentation?
= = = = = = = = =
• A. Adjustment disorder with depressed mood • B. Major
= = = = = = = = =
depressive disorder = =
• C. Persistent depressive disorder (dysthymia)
= = = = =
• D. Bereavement
= =
Answer: B = =
,Rationale: Major depressive disorder requires at least 2 weeks of
= = = = = = = = = =
depressed mood or anhedonia plus at least four additional
= = = = = = = =
symptoms (fatigue, concentration difficulties, insomnia, suicidal
= = = = = = =
ideation) . The patient has a 3- = = = = = =
week duration, multiple symptoms, and functional impairment.
= = = = = = =
Adjustment disorder requires an identifiable stressor and symptoms
= = = = = = =
within 3 months of the stressor, but the symptom severity and suicid
= = = = = = = = = = = =
al ideation suggest MDD. Persistent depressive disorder requires 2
= = = = = = = = =
years of symptoms. Bereavement is a normal grief response and
= = = = = = = = = =
would not typically include suicidal ideation.
= = = = = =
Cognitive Level: Analysis | Exam Domain: Depressive Disorders
= = = = = = = =
=
2. A 45-year-old male presents with a 2-
= = = = = =
year history of chronic depressed mood, low self-
= = = = = = =
esteem, and feelings of hopelessness. He states he has "never
= = = = = = = = = =
felt really happy" but can function at work. Which diagnosis is
= = = = = = = = = = =
most consistent with his presentation?
= = = = =
• A. Major depressive disorder
= = = =
• B. Persistent depressive disorder (dysthymia)
= = = = =
• C. Adjustment disorder
= = =
, =
• D. Bipolar II disorder
= = = =
Answer: B = =
Rationale: Persistent depressive disorder (dysthymia) requires
= = = = = =
depressed mood for at least 2 years in adults, with at least two ad
= = = = = = = = = = = = =
ditional symptoms (poor appetite, insomnia, low energy, low self-
= = = = = = = =
esteem, poor concentration, hopelessness) . The chronic course and
= = = = = = = = =
ability to function despite depressed mood are characteristic of
= = = = = = = =
dysthymia. Major depressive disorder may have distinct episodes
= = = = = = = = =
with return to baseline. Adjustment disorder is time-
= = = = = = =
limited after a stressor.
= = = =
Cognitive Level: Comprehension | Exam Domain: Depressive
= = = = = = =
Disorders =
=
3. A 28-year-old female presents with a 3-
= = = = = =
day history of elevated mood, decreased need for sleep,
= = = = = = = =
= grandiosity, and increased goal- = = =
directed activity. She reports this is the first time she has felt
= = = = = = = = = = = =
"this good" and has been spending excessive money. What is
= = = = = = = = = =
the most likely diagnosis?
= = = =
• A. Major depressive disorder
= = = =
, • B. Bipolar I disorder, manic episode
= = = = = =
• C. Bipolar II disorder, hypomanic episode
= = = = = =
• D. Cyclothymic disorder
= = =
Answer: B =
Rationale: A manic episode requires at least 1 week of abnormally
= = = = = = = = = =
elevated/irritable mood and increased energy, plus three or more
= = = = = = = = =
symptoms (grandiosity, decreased need for sleep, pressured spee
= = = = = = = =
ch, flight of ideas, distractibility, increased goaldirected activity, ris
= = = = = = = =
ky behaviors) . The symptom duration and severity (excessive spen
= = = = = = = = =
ding, functional impairment) indicate a manic episode consistent wit
= = = = = = = =
h Bipolar I disorder. Hypomania requires 4 days and less impairme
= = = = = = = = = =
nt. Cyclothymic disorder requires 2 years of cycling.
= = = = = = = =
Cognitive Level: Analysis | Exam Domain: Bipolar Disorders
= = = = = = = =
=
4. A 34-year-
=
old male with bipolar I disorder is prescribed lithium. What base
= = = = = = = = = =
line labs should the provider order before initiating therapy?
= = = = = = = = =
• A. Complete blood count and liver function tests
= = = = = = = =
• B. Serum creatinine, BUN, TSH, and pregnancy test
= = = = = = = =
